A nurse is analyzing test results for a client who has a pulmonary embolism. The nurse should identify that which of the following findings indicates a moderate to large pulmonary embolism and the possibility of death?

Tachycardia

Pleural effusion

Respiratory alkalosis

Increased troponin levels

Answer and Explanation

The Correct Answer is D

A. Tachycardia: Tachycardia is a common early sign of pulmonary embolism caused by hypoxia and sympathetic stimulation. However, it is nonspecific and not a direct indicator of embolism size or mortality risk.
B. Pleural effusion: A small pleural effusion can occur with a pulmonary embolism due to inflammation or infarction, but its presence does not correlate with embolism severity or predict outcomes such as death.
C. Respiratory alkalosis: Respiratory alkalosis is a typical response to hyperventilation in early PE. While common, it does not indicate the extent of the embolism or the risk of mortality and can be seen in mild cases.
D. Increased troponin levels: Elevated troponin indicates right ventricular strain or injury due to a moderate to large pulmonary embolism. This cardiac biomarker is associated with a higher risk of complications and death, signaling hemodynamic stress from the embolic event..

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Correct Answer is A

Explanation

A. Respiratory Acidosis, Uncompensated: The ABG results show a low pH (7.10), which indicates acidosis, and a high PaCO2 (70 mm Hg), which suggests that the acidosis is due to respiratory failure. The bicarbonate (HCO3) is within normal limits, indicating that the body has not had time to compensate for the acidosis, making it uncompensated.
B. Respiratory Alkalosis, Partially Compensated: This option is incorrect because respiratory alkalosis would present with a high pH, not a low pH as seen in this case.
C. Metabolic Alkalosis, Partially Compensated: The ABG shows respiratory acidosis, not metabolic alkalosis, as the pH is low and PaCO2 is high, suggesting respiratory problems rather than metabolic.
D. Metabolic Acidosis, Uncompensated: The ABG results point to respiratory acidosis, not metabolic acidosis. There is no indication of low bicarbonate levels (HCO3), which would be expected in metabolic acidosis.

A. Respiratory acidosis B. Metabolic acidosis C. Respiratory alkalosis D. Metabolic alkalosis

Correct Answer is A

Explanation

A. Respiratory acidosis: Clients with COPD have chronic difficulty exhaling carbon dioxide due to airflow obstruction, leading to CO₂ retention. This accumulation of carbon dioxide causes a drop in blood pH, resulting in respiratory acidosis, a common acid-base imbalance in COPD patients.
B. Metabolic acidosis: Metabolic acidosis results from increased acid production or loss of bicarbonate through the kidneys or gastrointestinal tract, such as in diabetic ketoacidosis or severe diarrhea. It is not typically associated with impaired ventilation or chronic lung disease like COPD.
C. Respiratory alkalosis: Respiratory alkalosis occurs when there is excessive loss of carbon dioxide due to hyperventilation. Clients with COPD generally hypoventilate rather than hyperventilate, making this acid-base imbalance unlikely in this case.
D. Metabolic alkalosis: Metabolic alkalosis is typically caused by loss of hydrogen ions through vomiting or diuretic use, or excessive bicarbonate intake. It is unrelated to the impaired gas exchange and CO₂ retention seen in clients with COPD.

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A nurse is analyzing test results for a client who has a pulmonary embolism. The nurse should identify that which of the following findings indicates a moderate to large pulmonary embolism and the possibility of death?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is A

Explanation

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Correct Answer is A

Explanation

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